祖先,种族和种族:解释心脏代谢疾病中的不平等
Sophie V Eastwood1, Gibran Hemani2, Sarah H Watkins2
1MRC Unit for Lifelong Health and Ageing at UCL Population Sciences and Experimental Medicine, Institute of Cardiovascular Sciences Faculty of Population Health Sciences, University College London, London, UK.
Trends in molecular medicine
|April 27, 2024
概括
心脏代谢疾病的种群差异不是主要是遗传的. 社会因素和终身环境暴露是关键驱动因素,需要关注医疗保健的社会经济障碍,以获得更好的结果.
科学领域:
- 公共卫生 公共卫生
- 遗传学 是一个遗传学.
- 社会学 社会学 社会学
背景情况:
- 心脏代谢性疾病 (CMD) 的人口差异很大,但人们对其了解甚少.
- 当前的术语 (祖先,种族,种族) 混了生物和环境因素,阻碍了准确的因果推断.
- 遗传变异只解释了种群之间观察到的CMD差异的很小一部分.
研究的目的:
- 批判性地评估基因变异与环境决定因素在CMD人口差异中的作用.
- 倡导将研究重点从遗传分层转移到对CMD的社会影响.
- 通过获得和遵守医疗保健来提出可行的策略,以减少CMD差异.
主要方法:
- 对CMD,遗传学和健康的社会决定因素的现有文献进行审查和综合.
- 分析术语对理解CMD病因学的影响.
- 制定一个解决CMD不平等问题的框架.
主要成果:
- 遗传因素对人口层面的CMD差异的贡献最小.
- 终身环境暴露和社会因素是CMD差异的主要驱动因素.
- 社会经济障碍严重阻碍了对CMD有效的医疗干预措施的获取和遵守.
结论:
- 将CMD差异归因于遗传学是误导性的;环境和社会因素至关重要.
- 基于人口分层的个性化医疗方法比解决社会经济障碍更不有效.
- 多学科合作和政策参与对于通过解决社会驱动因素来减少CMD不平等至关重要.
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